Does your facility require documentation of site/device where medications or IV fluids, administered continuous or intermittently are infusing? If yes, please delineate when (once/shift, with each bag/syringe change or other?) Is it charted in the same section as the site assessment? Do you chart by exception?
My answer is based on many years of reviewing medical records for lawsuits. I would strongly urge you to make this a requirement for your nursing staff. It will only serve to protect them. I can not tell you how many legal cases I have reviewed where there was no indication as to what site or lumen was used for which medications. This causes lots of confusion and it could easily serve to produce a win for the plaintiff or patient and a loss for the defendant - the nurse and hospital. As the expert, I need to able to find the exact infusion site or lumen for any fluid or medication in question. Likewise I also need to know the exact anatomical location of all venipunctures. If an infusion is given through one site, but there have been numerous other puncture sites nearby, this can allow leakage of vesicants from many sites. If there is a lack of blood return or no documentation of blood return from a site or lumen, this also is a huge problem for the defense of nursing action. Depositions and trials in these cases take place many years after the event occurred. No one can remember that specific patient and their actions for that long. So your documentation will serve to help or hurt the nurse. Also remember that all nurses will be measured by the INS standards of practice plus other documents such as CDC, etc. These documents are written to apply to all nurses, not just infusion nurses. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Lynn, thank you so much for your comments. I absolutely agree with you but have been fighting an extreme uphill battle. Our Risk department also concurs, but management has not taken the recommendation to heart.
I really appreciate your feedback. Thanks again.